The importance of contextual factors and age in association with anxiety and depression in Black breast cancer patients
Article first published online: 22 OCT 2013
Copyright © 2013 John Wiley & Sons, Ltd.
Volume 23, Issue 2, pages 143–150, February 2014
How to Cite
Sheppard, V. B., Harper, F. W. K., Davis, K., Hirpa, F. and Makambi, K. (2014), The importance of contextual factors and age in association with anxiety and depression in Black breast cancer patients. Psycho-Oncology, 23: 143–150. doi: 10.1002/pon.3382
- Issue published online: 17 JAN 2014
- Article first published online: 22 OCT 2013
- Manuscript Accepted: 23 JUL 2013
- Manuscript Revised: 12 JUL 2013
- Manuscript Received: 24 OCT 2012
- American Cancer Society. Grant Number: Sheppard: PI MRSGT-06-132 CPPB
- NIH Health Disparities Loan Repayment Award. Grant Number: 2L60MD000291-02
- NIH/NCI. Grant Number: Sheppard: PI, R01CA154848
Limited research exists on correlates of psychosocial distress in Black breast cancer patients. The goals of the study were to describe the prevalence of distress (anxiety and depression) in Black women with breast cancer and to examine the influence of demographic, clinical, contextual (e.g., self-efficacy, medical mistrust), and process of care factors (e.g., patient satisfaction) on women's level of anxiety and depression.
Eighty-two Black women diagnosed with invasive non-metastatic breast cancer were interviewed by phone. Collected data included demographic, clinical, contextual, and process of care factors. Bivariate correlations were used to examine relationships between those variables. Multiple linear regressions were used to examine predictors of anxiety and depression.
About one-third of the women (32%) met cut-off thresholds for distress. Medical mistrust and positive attitude had significant influences on anxiety levels, whereas age and positive attitude were determinants of levels of depression. Participants with higher medical mistrust reported more anxiety (r = .379; p < .001) and depression (r = .337; p = .002), whereas women with higher self-efficacy reported less anxiety (r = −.401; p < .001) and depression (r = −.427; p < .001). Age was inversely related to both anxiety and depression (r = −.224; r = −.296, respectively; p < .05).
Findings support national recommendations for routine distress screening in the delivery of cancer care particularly in younger Black patients. Interventions targeted to boost self-efficacy or reduce medical mistrust through enhanced patient–provider interactions may decrease psychological distress. Psychosocial needs of younger patients warrant particular attention. Copyright © 2013 John Wiley & Sons, Ltd.